Simple schematic representation of the Markov model.

<p>All patients started at age 65 in the “well” with atrial fibrillation health state and then cycled between health states until death occurred or lifetime follow-up period ended (whichever came first). Only certain transitions were allowed and patients could never transition to a more favorable health state. The length of each cycle was 2 weeks and patients could only experience one event of any kind per cycle. Any health state could lead directly to death (not depicted). A second minor ischemic stroke resulted in a major ischemic stroke and that a second major ischemic stroke resulted in death. Temporary health states (e.g., minor bleed and non-fatal extracranial bleed) are not depicted in the figure. The health states were equivalent for apixaban and warfarin, but the probabilities, costs and utilities (quality-of-life) varied with treatment.